Federal law requires that all of the performance measuresbe published on the “Hospital Compare” section ofMedicare’s website ( www.hospitalcompare.hhs.gov).

the DHHS must announce the performance standards with respect to each performance measure at least 60 days prior
to the beginning of the performance
period for the respective fiscal year.

CMS has selected 13 performancemeasures to be used in the Program forfiscal year 2013, including, for illustra-tion, each of the following:• Percent of heart attack patients givenPCI procedures (ie, procedures effec-tive for opening blocked blood vessels)within 90 minutes of arrival.

not only upon the quality measures but
also efficiency standards such as Medicare spending per beneficiary, which will
be risk adjusted to take into consideration age, sex, race, severity of illness, etc.

Because information regarding each
hospital’s performance under the Program will be published on the Hospital
Compare website, which is designed to
present data in a clear and concise manner that can be easily accessed and understood by the general public, a hospital’s
achievements (or lack of achievements)
under the Program may have a significant
impact upon its reputation and therefore
its long term financial success. By visiting the CMS Hospital Compare website,
those within the medical imaging community can achieve a useful understanding of the website’s scope, function, and
potential impact upon the industry.

The patient experience of care measure will be based upon the Hospital
Consumer Assessment of Health Care
Providers and Systems (HCAHPS) survey, which is a measure currently used
under the Medicare Inpatient Quality
Reporting (IQR) program and available
on the Hospital Compare website. The
patient experience domain score (ie,
HCAHPS performance) will account for
30% of a hospital’s total performance
score under the Program for fiscal year
2013. Although none of the Program’s
measures for fiscal year 2013 focus on
medical imaging specifically, the quality of medical imaging provided to patients in hospital inpatient imaging departments and otherwise will certainly
impact the patients’ overall experience
of care. Furthermore, it is possible that
future measures will target imaging more
directly. Beginning in fiscal year 2014,
the Program will begin to determine payments to participating hospitals based

Paying for the Program

fifty million dollars is expected to be allocated to hospitals under the Program
during fiscal year 2013. Each participating hospital will be scored based upon
their performance compared to that of
other hospitals (ie, their achievement
scores) and also based upon how their
own performance has improved over
time (ie, their improvement scores). The
participants who receive the highest performance scores under the program will
receive the highest level of incentive payments. That being said, many (perhaps
close to one-half) of participating hospitals will experience an overall reduction
in payments as a result of this program.

The Medicare Hospital Value-Based
Purchasing Program is designed to gradually become more powerful and more
stringent. The amount of the Medicare
payment reduction and also the related
Medicare financial incentives that will
be payable under the Program, both of
which are described further above, will
increase over time and those performance measures that experience a high
level of compliance among participants
will be replaced with measures that are
more difficult to achieve.

Medicare will pay for the Hospital Value-Based Purchasing Program through a
two-step redistribution process. First,
Medicare will reduce the Medicare Inpatient Prospective Payment System
payments (more specifically, the base
operating DRG payment) that all hospitals would have otherwise received. The
reduction just described will equal 1%
during fiscal year 2013 and will gradually increase to 2% for fiscal year 2017
and after. Second, Medicare will increase
such payments to certain hospitals based
upon their success relative to the various
performance measures. 2 Eight hundred

Conclusion

Like many initiatives adopted pursuant
to the 2010 Federal healthcare reform
legislation, the Medicare Hospital Value-Based Purchasing Program serves as a
catalyst for the current wave of integration among healthcare providers. In order to achieve the quality and efficiency
goals embraced by the Program, hospitals
will need the support of their physicians
and other clinical and non-clinical staff
members. In light of this fact and other
market and societal factors, hospitals
and health systems across the country

Although none of the Program’s measures for fiscal year 2013focus on medical imaging specifically, the quality of medicalimaging provided to patients . . . will certainly impactthe patients’ overall experience of care.